insurance-ivig-drk?

[danddd]

I am set to have a phone consult w/ drk in a couple weeks, very nervous but hopeful about it. but I was just reading in the other post that if he were to recommend ivig, you have to pay up front for it and then if your lucky be reimbursed?

even if it is done at hospital, they dont submit to ins. ?

so........... are there any docs who are sometimes willing to give ivig when needed, and take ins.?

 

I am lost again!

 

oh, does anyone know of a boston doc who has worked with drk (or another good doc) to have ivig done locally?

[MomWithOCDSon]

I am set to have a phone consult w/ drk in a couple weeks, very nervous but hopeful about it. but I was just reading in the other post that if he were to recommend ivig, you have to pay up front for it and then if your lucky be reimbursed?

even if it is done at hospital, they dont submit to ins. ?

so........... are there any docs who are sometimes willing to give ivig when needed, and take ins.?

 

I am lost again!

 

oh, does anyone know of a boston doc who has worked with drk (or another good doc) to have ivig done locally?

 

Unless your child has another identifiable immune condition (such as immune deficiency), most (dare I say "all" now that Universal Healthcare has changed its policy?) insurance will not accept a "PANDAS" diagnosis as appropriate for IVIG treatment. I don't think it even has a code for most insurance companies, so perhaps that's why prepayment is necessary?

[sf_mom]

You need to try Dr. B. in CT. See my comments. http://www.latitudes.org/forums/index.php?...art=#entry69721

[jayjay]

You need to try Dr. B. in CT. See my comments. http://www.latitudes.org/forums/index.php?...art=#entry69721

 

My son just had IVIG with Dr. B. last week. He told us my son was only the second person that he was not able to get covered by insurance. We have United Healtcare / Oxford. They would have covered if his bloodwork showed he was immune deficient. Which he is not. Dr. B. submitted it as autoimmune which UHC considers IVIG expieremental and investigational. I think it really depends on the insurance company. We just happen to have one of the worst.

[bmom]

Could I ask what the total of the IVIG was? Perhaps it is worth going to Dr. B if it is a less amount. Does he do phone consults? Will he do an appointment and then IVIG in one visit if we are coming across country?

[jayjay]

Could I ask what the total of the IVIG was? Perhaps it is worth going to Dr. B if it is a less amount. Does he do phone consults? Will he do an appointment and then IVIG in one visit if we are coming across country?

I'm not sure you could do it all in one appointment. He does do phone consults so that is something you could ask. I believe they gave us a break because we had to pay out of pocket. The total was $8,000.00. My son weighs 95 lbs.

[Joan Pandas Mom]

I have anthem BC&BS and just got the rejection letter yesterday. We had IVIG with Dr. K. on the 20 and 21 of May. They said, "the use of IVIG for that condition is considered investigational and not medically necessary." I am going to appeal it.

[danddd]

I have anthem BC&BS and just got the rejection letter yesterday. We had IVIG with Dr. K. on the 20 and 21 of May. They said, "the use of IVIG for that condition is considered investigational and not medically necessary." I am going to appeal it.

 

 

wow even bc&bs denied! keep fighting, hope you get it.

so maybe i should just look in to seeing dr.b if we dont have to pay up front.

dd is not immune deficient , so that wouldnt work as a reason.

$8000 for 95 lbs. is cheaper than chicago......

is everyone generally happy with the results?

[jayjay]

I have anthem BC&BS and just got the rejection letter yesterday. We had IVIG with Dr. K. on the 20 and 21 of May. They said, "the use of IVIG for that condition is considered investigational and not medically necessary." I am going to appeal it.

 

 

wow even bc&bs denied! keep fighting, hope you get it.

so maybe i should just look in to seeing dr.b if we dont have to pay up front.

dd is not immune deficient , so that wouldnt work as a reason.

$8000 for 95 lbs. is cheaper than chicago......

is everyone generally happy with the results?

Just to clarify, we did have to pay up front. We had to give the the $8,00.00 check before we left the second day of the IVIG treatment. As for results, he is just a week out and has been very sick since the IVIG. Stomach ache, vomiting, nausea. Dr. thinks he contacted a stomach bug and it's not from IVIG. I think there is a grey cloud hanging over our heads : (

[bmom]

Does Dr. B do the exact IVIG that Dr. K does?